<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376101050
Report Date: 05/26/2022
Date Signed: 05/26/2022 12:38:06 PM

Document Has Been Signed on 05/26/2022 12:38 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:ARYOUBI, BIBI SADIA FAMILY CHILD CAREFACILITY NUMBER:
376101050
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
05/26/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
10:39 AM
MET WITH:Bibi AryoubiTIME COMPLETED:
12:42 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA), Tyra Block, conducted an announced Pre-Licensing inspection with the applicant and minor sister who assisted with translation. The 2 story, 4 bdrm, 2.5 ba home was toured and inspected to ensure an environment safe for the care and supervision of children. The fire extinguisher (2A10BC), carbon monoxide detector and smoke detector meet requirements and are operational. All poisons, cleaners, and hazardous items were latched/locked and secured out of reach of children, and electrical outlets were covered. There are no bodies of water in the home. Applicant states that there are no firearms or weapons in the home. Applicant has certified on their application they have sufficient financial resources to sustain the license. Applicant has provided proof of control of property. A review of staff records on this date indicates that all residents or other individuals who require caregiver background checks have received criminal record and child abuse clearances or exemptions. First Aid and CPR expire on 12/2023 and preventative health practices course was completed on 12/2021. Mandated Reporter Training was not completed due to training not available in Pashto, applicant has limited English proficiency. Staff/ resident TB clearance and immunization requirements were met.
Applicant will be using the following rooms for childcare: living room, kitchen, and downstairs bathroom. The following areas will be off limits: garage, storage closets, and entire upstairs which is made off-limits with child safety gate and door lever locks. The home has a fenced backyard available for outdoor activities and toys are available for children to use. Applicant understands visual supervision is to be maintained at all times when taken off-site. LPA advised no changes should be made to the home without prior notice and/or approval from Licensing.
LPA reviewed with applicant the LIC 311D, Forms/Records To Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. The new provider packet was reviewed with the applicant including information on the effects of lead, child abuse reporting, roster and emergency drill log example, visual for ratio/capacity, immunizations, adults living or working in the home, shaken baby syndrome, SIDS, a Guide to Safe Sleep (Safe Sleep Concepts dated 4/2018 provided), COVID-19 Child Care Guidance, and the YMCA Resource Center.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Tyra Block
LICENSING EVALUATOR SIGNATURE: DATE: 05/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/26/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: ARYOUBI, BIBI SADIA FAMILY CHILD CARE
FACILITY NUMBER: 376101050
VISIT DATE: 05/26/2022
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Applicant was reminded that corporal punishment, smoking, walkers, exersaucers, jumpers and bouncy seats are not allowed in day care (prohibited items visual). Also discussed community resources, liability insurance, obtaining a tax ID. All equipment that is used should be used only as intended by the manufacturer. LPA and applicant discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov.

LPA discussed the safe sleep regulations with applicant and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed applicant of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

LPA discussed that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated. Any minor upon his/her 18th birthday must be fingerprinted within 30 days.




Incidental Medical services (IMS) policy was discussed. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Tyra Block
LICENSING EVALUATOR SIGNATURE:

DATE: 05/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/26/2022
LIC809 (FAS) - (06/04)
Page: 3 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: ARYOUBI, BIBI SADIA FAMILY CHILD CARE
FACILITY NUMBER: 376101050
VISIT DATE: 05/26/2022
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform. To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication. Applicant was encouraged to subscribe.

Applicant is advised to regularly visit the Community Care Licensing WEB SITE: http://www.ccld.ca.gov/ for forms and updated regulation information. Duty Line was provided: (619) 767-2248. Southern California Child Care Advocate information was provided: (714) 703-2800 or childcareadvocatesprogram@dss.ca.gov.



No corrections are needed. A license for 8 children will be issued after a thorough file review.

LPA discussed the following with Applicant: maximum capacity for a small family child care home: 4 infants only (infants mean any children under 24 months); or 6 children with no more than 3 infants; or (with landlord consent) 8 children with no more than 2 infants, 1 child in kindergarten or elementary school and 1 child at least age 6 including children under age 10 who live in the licensee's home. Parent Notification of Additional Children in Care must also been maintained in each child’s file if caring for more than 6 children.

Exit interview conducted and report was reviewed with the applicant, Bibi Aryoubi and sister.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Tyra Block
LICENSING EVALUATOR SIGNATURE:

DATE: 05/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/26/2022
LIC809 (FAS) - (06/04)
Page: 4 of 4